Measuring outcomes of care for adolescents with emotional and behavioral problems

Objectives: To validate the prototype Adolescent Treatment Outcomes Module (ATOM), examine its sensitivity to clinical change, and determine its feasi bility for administration in routine clinical settings. Method: A sample of 67 adolescents, aged 11 through 18, was selected from new patients at two inpatient and two outpatient mental health programs. Adolescents and parent s completed the ATOM and validating instruments at intake, 1 week postintak e, and again at 6 months. Results: Nine self-report symptoms predicted posi tive diagnoses of oppositional defiant, conduct, anxiety, and depressive di sorders on the basis of structured diagnoses, with sensitivities of 0.7 to 0.8. Test-retest correlations for outcome scales were largely excellent (>0 .70). Scales that measured functioning at home, in school. and in the commu nity were moderately correlated in the expected direction with global funct ioning. Decreases in symptom severity and functional impairment were genera lly associated with decreases in validating instruments. Administration tim e averaged 25 minutes for adolescents and 28 minutes for parents. Conclusio ns: Both parents and adolescents readily completed the ATOM. Module scales demonstrated excellent reliability and good to fair concurrent validity. Th e ATOM was able to detect change and its absence.